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A Day in the Life of a NICU Doctor

An Overview of the NICU

Dr. La Gamma works within a network of neonatal intensive care programs at 11 hospitals across the Lower Hudson Valley Region of New York State.

"To give you an idea of how the division I work within is organized, there are four levels of neonatal services for pregnant women and newborns, depending on the level of care that's needed.

Level I is for pregnant women and newborns who are at low risk. Level II is for pregnant women and newborns with moderate risk for complications, such as a mother with gestational diabetes. These services are what you'd find at your community hospital. Level III is high risk, and Level IV is the highest risk. Levels III and IV provide care and services for babies who are preemies or who need special treatment in neonatal intensive care units (the NICU).

For example, babies who are below 2.2 pounds -- micro preemies -- make up only .5 percent of all births, about 110 per year in the NICU. The highest risk for delays and complications -- a whole slew of things -- these are those babies. Babies who are born with acute illness, respiratory problems, babies with total lung or total heart failure who need ECMO (Extra Corporeal Membrane Oxygenation), cardiac surgery cases, abdominal surgery cases, neurosurgery, orthopedic surgery -- these are other examples of the types of complications we face.

Ninety-five percent of the time labor and delivery goes well but there is always potential for something to go wrong. The rare and unusual becomes common for us."